Insurance and Billing

Forms of Payment

Groundswell Acupuncture accepts:

I can also provide you with a Superbill, which you can send in to your health insurance company for reimbursement.

Payment is due the day of the visit.

Health Insurance

In Network:

Cigna

United Healthcare

Anthem - Blue Cross Blue Shield

Tri-West

Insurance Company Recommendations

Groundswell Acupuncture works with many insurance companies – both in and out of network.

In order to receive full benefits from your health insurance provider, we suggest for you to call your insurance carrier – the contact number is usually found on the back of your insurance card – and ask what is covered on your policy.

You will need to ask the following questions:

Does my policy cover acupuncture treatments?

How many treatments are covered per year?

Possible answers:

a) unlimited. This is going to mean that you can get three treatments per week for as long as necessary. By the time you start thinking about acupuncture, you have probably been through a great many different treatments. The reason this matters is that for every year you have had a problem, expect one month to fix it.

b) 35 per year. This too is going to get the job done in many cases. Generally acute conditions (meaning that they are really intense, but do not last that long or came on quickly) are going to respond better than the low-grade long-term chronic issues. Still, even for the chronic issues, 35 treatments inside of a year should be a pretty good start.

c) 12 per year. Now, we are pretty much limited to a few key issues that just so happen to respond quickly to acupuncture. These would be stress or hormonally induced issues among sensitive individuals such as PMS where you only need one treatment per month, or else some other musculo-skeletal problem where it is simply a sprain or strain, perhaps a pinched nerve. All these things can respond rather quickly, so 12 treatments may do what is necessary.

3.Does this number also include any other therapies?

a) No, coverage is only for acupuncture.

b) The use of chiropractic, physical therapy, or other therapy is also covered by your insurance. Sometimes that acupuncture benefit for 35 sessions per year is shared by all these other complementary modalities. You will want to find that out too, especially if you are getting physical therapy, for instance.

4.Who must provide the acupuncture?

a) Anyone who is licensed to perform acupuncture in your state.

b) Only employees in an HMO facility can provide your acupuncture. This is often an MD with or without extensive training who works in the HMO facility.

c) Only an MD or a physical therapist may bill for your acupuncture benefits.

5.Does my policy cover 100% or some portion of the treatment?

a) Sometimes, a policy will only cover 70-80% of the cost of the treatment, regardless of the cost and in most situations the patient is responsible for the remaining 30-20% (so-called co-insurance fees).

6. Is there a deductible and if there is – how much of it has been met?

a) A deductible is the portion not covered by the insurance coverage. So if you have $250 deductible, you will need to submit $250 in medical costs before your insurance company will pay for the treatment. Note that this is medical costs, not just acupuncture!

7. Which pathologies are covered? Does my policy cover the condition for which I am seeking treatment?

a) There is no restriction.

b) Pain syndromes only. If I'm treating you for diarrhea, for example, and you are having stomach pain, insurance will pay for treatment of pain and both problems will be treated during the single acupuncture session.

c) Musculo-skeletal pain not including headaches or menstrual cramps or pain that can be treated by other methods.

Most policies do not cover weight management and smoking cessation, however, many people seeking these treatments also require treatment for conditions covered by acupuncture.